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General NPI Number Information
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NPI Number | 1265661680
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Entity Type | Individual
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Provider Name | JESSIN HELMRICK-BLOSSOM M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 3320 SW 34TH CIR
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City | OCALA
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State | FL
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Zip | 34474-3371
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Country | US
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Telephone | 352-629-8154
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Fax | 352-629-5231
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Provider Business Mailing Address
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Address Line | 3320 SW 34TH CIR
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City | OCALA
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State | FL
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Zip | 34474-3371
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Country | US
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Telephone | 352-629-8154
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Fax | 352-629-5231
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME143048
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | ME143048
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License Number State | FL
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